Health in Brazil

This Blog Post ia about Health in Brazil

The healthcare in Brazil is provided by both private and government institutions. The Minister for Health and Ageing administers national health policy. Primary health care remains the responsibility of the federal government, elements of which (such as the operation of hospitals) are overseen by individual states. Public health care is provided to all Brazilian permanent residents and is free at the point of need (being paid for from general taxation). The country is home to a number of international health organizations, such as the Latin American and Caribbean Center on Health Sciences Information, and the Edumed Institute for Education in Medicine and Health.

Health

According to the Brazilian Government, the most serious health problems are:[3]

Childhood mortality: about 2.51% of childhood mortality, reaching 3.77% in the northeast region.

Motherhood mortality: about 73.1 deaths per 100,000 born children in 2002.

Mortality by non-transmissible illness: 151.7 deaths per 100,000 inhabitants caused by heart and circulatory diseases, along with 72.7 deaths per 100,000 inhabitants caused by cancer.

Mortality caused by external causes (transportation, violence and suicide): 71.7 deaths per 100,000 inhabitants (14.9% of all deaths in the country), reaching 82.3 deaths in the southeast region.

In 2002, Brazil accounted for 40% of malaria cases in the Americas.[4] Nearly 99% are concentrated in the Legal Amazon Region, which is home to not more than 12% of the population.[4]

Life expectancy

The life expectancy of the Brazilian population increased from 69.66 years in 1998 to 72.86 years in 2008, according to the Brazilian Institute of Geography and Statistics (IBGE) and Tuesday's Brazilian Official Gazette. Men's life expectancy was 69.11 years and women's was 76. 71 years last year. The data indicate a significant progress compared with 45.50 years in 1940. According to the IBGE, Brazil will need some time to catch up with Japan, Hong Kong (China), Switzerland, Iceland, Australia, France and Italy, where the average life expectancy is already over 81. Research has shown that Brazil would achieve that level by 2040.

The data came from the IBGE's Complete Mortality Tables for Brazil's population, which have been published annually since 1999. They are used by the Ministry of Social Security as one of the parameters for the retirement fund factor under the General System of Social Security.[5]

Demographic projections foresee the continuation of this process, estimating a life expectancy in Brazil around 77.4 years in 2030. The decline in mortality at young ages and the increase in longevity, combined with the decline of fecundity and the accentuated increase of degenerative chronic diseases, caused a rapid process of demographic and epidemiologic transition, imposing a new public health agenda in the face of the complexity of the new morbidity pattern.[6]

Infant mortality

Child health is a central issue on the public policy agenda of developing countries. Several policies geared to improving child health have been implemented over the years, with varying degrees of success. In Brazil, such policies have led to a significant decline in infant mortality rates over the last 30 years. Despite this improvement, however, mortality rates are still high by international standards and there is substantial variation across Brazilian municipalities, which suggests that differentiated policies should be devised. The aim of this paper is to investigate the determinants of infant mortality at the municipal level, and to provide a more detailed analysis by considering the factors that affect child health at the individual level. To analyze the mortality rate, static and dynamic panel data models are estimated using four censuses covering the period 1970-2000. The demand for child health is addressed through a household decision model, estimated using anthropometric data from the 1996 Standard of Living Survey. The results indicate that sanitation, education and per capita income contributed to the decline in infant mortality in Brazil, the effects being stronger in the long run than in the short run. The fixed effects associated with municipality characteristics help explain the observed dispersion in child mortality rates. The results of the decision model are in line with the mortality model findings: education, sanitation and poverty are the most important explanatory factors of poor child health in Brazil.[7]

UNICEF report shows a rising rate of survival for Brazilian children under the age of five. UNICEF says that out of a total of 195 countries analyzed, Brazil is among the 25 nations with the best improvement in survival rates for children under the age of 5. The report shows that Brazil's infant mortality rate for live births in 2008 was 22 per thousand, a drop of 61% since 1990. Mortality rates for children at one year of age was 18 per thousand, a reduction of 60%. The study went on to show that malnutrition among children of less than two years of age during the period between 2000 and 2008 fell by 77%. There was also a substantial drop in the number of school age children who were not in school, falling from 920,000 to 570,000 during the same period. Cristina Albuquerque, coordinator of the UNICEF Infant Survival and Development Program called the numbers "an enormous victory" for Brazil. She added that with regard to public policy aimed at reducing social disparities, Brazil's Bolsa Família program had become an international benchmark in combating poverty, reducing vulnerability and improving quality of life. "Brazil is going through a great moment, but much remains to be done. So, along with the celebrating it is a good time to reflect on the many challenges still to be overcome," Albuquerque declared.[8]

Health care system

National health policies and plans: The national health policy is based on the Federal Constitution of 1988, which sets out the principles and directives for the delivery of health care in the country through the Unified Health System (SUS). Under the constitution, the activities of the federal government are to be based on multiyear plans approved by the national congress for four-year periods. The essential objectives for the health sector were improvement of the overall health situation, with emphasis on reduction of child mortality, and political-institutional reorganization of the sector, with a view to enhancing the operative capacity of the SUS. The plan for the next period (2000–2003) reinforces the previous objectives and prioritizes measures to ensure access at activities and services, improve care, and consolidate the decentralization of SUS management.

Health sector reform

The current legal provisions governing the operation of the health system, instituted in 1996, seek to shift responsibility for administration of the SUS to municipal governments, with technical and financial cooperation from the federal government and states. Another regionalization initiative is the creation of health consortia, which pools the resources of several neighboring municipalities. An important instrument of support for regionalization is the Project to Strengthening and Reorganization the SUS.

Regulatory actions

Procedures for the registration, control, and labeling of foods are established under federal legislation, which assigns specific responsibilities to the health and agriculture sectors. In the health sector, health inspection activities have been decentralized to the state and municipal governments. The environmental policy derives from specific legislation and from the Constitution of 1998.

Public health care services

The main strategy for strengthening primary health care is the Family Health Program, introduced by the municipal health secretariats in collaboration with the states and the Ministry of Public Health. The federal government supplies technical support and transfers funding through Piso de Atenção Básica. Disease prevention and control activities follow guidelines established by technical experts in the Ministry of Public Health. The National Epidemiology Center (CENEPI), an agency of the National Health Foundation (FUNASA) coordinates the national epidemiological surveillance system, which provides information about and analysis of the national health situation.

Individual health care services

In 1999, 66% of the country's 7,806 hospitals, 70% of its 485,000 hospital beds, and 87% of its 723 specialized hospitals belonged to the private sector. In the area of diagnostic support and therapy, 95% of the 7,318 establishments were also private. 73% of the 41,000 ambulatory care facilities were operated by the public. Hospital beds in the public sector were distributed as follows: surgery (21%), clinical medicine (30%), pediatrics (17%), obstetrics (14%), psychiatry (11%) and other areas (7%). In the same year, 43% of public hospital beds, and half the hospital admissions were in municipal establishments. Since 1999, the Ministry of Public Health has been carrying out a health surveillance project in Amazonia that includes epidemiological and environmental health surveillance, indigenous health and disease control components. With US 600 million dollars from a World Bank loan, efforts are being made to improve the operational infrastructure, training of human resources and research studies. An estimated 25% of the population is covered by at least one form of health insurance; 75% of the insurance plans are offered by commercial operators and companies with self-managed plans.

Health in Brazil